NCG160173 DMR SW (4)

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Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Permit No. NCG160000-Asphalt
Date submitted C ` "" l
Paloo
CERTIFICATE OF COVERAGE NO. N r '—'7) SAMPLE COLLECTION YEAR
FACILITY NAME " -7 �LY� �L n5�1�l lJE SAMPLE PERIOD • Jan-June ❑July-Dec
COUNTY e7C-1,11-EWRUI FFyyor ❑ Monthly1 (month)
PERSON COLLE ING SAMPLES (1 HAlk.65 A <-/Y N17.7f DISCHARGING TO CLASS ❑ORW ❑HQW ETrout EPNA
LABORATORY IS/V1 Lab Cert.# ❑Zero-flow ❑Water Supply ESA
Comments on sample collection or analysis: ROther et.gS.A Q
RECEIVED
PLEASE REMEMBER TO SIGN ON THE REVERSE -> .
JUN 0 /016
Part A:Stormwater Benchmarks and Monitoring Results CENTRAL FILES
DWR SFC:TICN ❑ No discharge this period.
Date Sample 24-hour rainfall
Outfall No. 1
Collected amount, •
(mo/dd/yr) Inches3 Total Suspended Solids
Benchmarks=__> - - 100 mg/L
06119/ . h() � q ��tr
•
1 Monthly sampling(instead of semi-annual)must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall,you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on-site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
a See General Permit text,Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note:Results must be reported in numerical format. For example,do not report Below Detection Limit, BDL,<PQL, Non-detect, ND,or other similar non:-
numerical
on-numerical format. When results are below the applicable limits,they must be reported in the format,"<XX mg/L",where XX is the numerical value of the
detection limit, reporting limit,quantitation limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark,you must implement Tier 1, Tier 2,or Tier 3 responses. See General Permit text,
Permit Date:10/1/2014-9/31/2019 • SWU-252,last revised 9/17/2014
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'''Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging>55 gal of new oil per month.
4. j
(�` A ❑ No discharge this period?2
Date Sample 24-hour rainfall
Outfall No. i
Collectedd amount, Non-polar O&G by EPA Total Suspended Solids
(mo/dd/yr) Inches 1664(SGT-HEM)
Benchmarks===> _ - 15 mg/L 100 mg/L or 50 mg/L4
:a'
Footnotes from Part A also apply to this Part B •
Note: If you report a sample value in excess of the benchmark,you must implement Tier 1, Tier 2,or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO1
IF YES,HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES 111NO III
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, includinq all"No Discharge"reports,within 30 days of receipt of the lab results(or at end of monitoring period
in the case of"No Discharge"reports)to:
Division of Water Resources
Attn: DWR Central Files . '
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: '
"I certify,under penalty of law,that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system,or
those persons directly responsible for gathering the information,the information submitted is,to the best of my knowledge and belief,true,accurate,and complete. I
. am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations."
C7Z2::;2C---L3 • -7 -/6
(Signature of Permittee) • (Date) '
•
Permit Date: 10/1/2014-9/31/2019 • SWU-252,last revised 9/17/2014
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